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A '''urinary tract infection''', also commonly known as a '''UTI''', is a bacterial [[infection ]] in the urinary tract (kidneys, ureters, bladder and/or [[urethra]]). UTIs can affect both males and females, although, due to the difference in structures of the male and female urinary tract, infections occur most commonly in girls and women, as the urinary tract is shorter in females than it is in males. UTIs can become serious if undetected, and may lead to permanent kidney damage. However, they are easily and effectively treated with antibiotics.<ref name="ginsburg uti">{{REFjournal

}}</ref><ref name="McCracken 1989">{{REFjournal

UTIs are often caused by ''Escherichia coli'' (E. coli) bacteria, to which the infant has no passive immunity. In infant girls UTIs generally originate in the colon, whereas in infant boys they originate from the external environment, strongly suggesting that for boys such infections [[infection]]s are [[iatrogenic]].<ref>{{REFjournal

}}</ref> Although ''E. coli'' is one of the most common bacteria on the surface of human [[skin]], strains found in hospitals tend to be particularly virulent. ''E. coli'' that live in the intestinal tract cause urinary tract infections when allowed to get into the sterile urinary tract. Whether intact or circumcised, baby boys sitting in poopy diapers allows ''E. coli'' an opportunity to enter the urinary tract. And, of course, fiddling with the [[foreskin ]] and introducing bacteria foreign to the baby's body or his urinary tract can also cause UTI, too. The tight [[foreskin]] of the infant boy acts as a sphincter to allow [[urine]] to flow out, but prevents contaminants and pathogens from coming in.<ref name="Fleiss 1998">{{REFjournal |last=Fleiss |init=PM |author-link=Paul M. Fleiss |last2=Hodges |init2=FM |author2-link=Frederick M. Hodges |last3=Van Howe |init3=RS |author3-link=Robert Van Howe |url=http://www.cirp.org/library/disease/STD/fleiss3/ |title=Immunological functions of the human prepuce |journal=Sex Trans Infect |location=London |volume=74 |issue=5 |pages=364-367 |date=FleissP HodgesF VanHoweRS 1998-10 |accessdate=2019-10-31}}</ref>

In infant boys, UTIs originate from the external environment, strongly suggesting that these infections are [[iatrogenic| iatrogenically ]] caused.<ref>{{REFjournal

}}</ref> which binds to the [[glans penis ]] of the infant.<ref name="Cunningham 1986">{{REFjournal

}}</ref> Urinary tract infections (UTI) are a [[complication ]] of [[circumcision]].<ref>{{REFjournal

The most common way of relieving a urinary tract infection is the administration of prescription antibiotics,<ref name="ginsburg uti"/> <ref name="McCracken 1989"/> if the infection does not clear up on its own. Drinking cranberry juice is a home remedy that may also help.

|init4last4=Lohr

It was determined in the 1990s that [[breastfeeding ]] plays a central role substantially reducing the incidence of UTIs.<ref name="Winberg 1989"/><ref>{{REFjournal

Rooming-in permits colonization of the infant's [[skin ]] and [[mucosa]] with the mother's own bacteria. The prepuce and other [[skin ]] and [[mucosa]] of the infant should be specifically brought into contact with the mother's own [[skin ]] to pass along her flora and initiate the child's natural immunity.<ref>{{REFjournal

Parents should be careful not to [[Forced retraction|forcibly retract]] the [[foreskin ]] of a baby's penis, and to instruct the child's doctor and/or caretaker likewise. The act of forced retraction involves forcible separation that destroys a structural defense mechanism; the [[synechia]] which binds the foreskin to the glans is torn away, which allows E. coli to invade where it could not before.<ref name="Winberg 1989"/>

As [[circumcision ]] necessitates [[forced retraction]] of the foreskin, additionally creating an open wound that is vulnerable to additional infection, parents are advised against circumcision.<ref name="Outerbridge 1998"/> These functions suggest that the [[intact ]] prepuce may offer protection against UTI if undisturbed. The [[foreskin]] provides two physical lines of defense in the intact male child, which are removed in circumcision: the preputial sphincter, which closes when a boy is not urinating, and a protected meatus (urinary opening), which is often inflamed and open in circumcised boys.<ref name="Cunningham 1986"/> Recently, Fleiss et al. (1998) reviewed the immunological functions of the prepuce. In addition, the sub-preputial moisture contains lysosyme, which has an anti-bacterial action.<ref name="Fleiss 1998"/> Oligosaccharides excreted in the [[urine]] of breastfed babies prevent adhesion of pathogens to uroepithelial tissue.<ref name="Marild 1990"/>

Drs. Charles Ginsburg & George McCracken (1982) carried out a study of UTI in boys at [https://www.parklandhospital.com/ Parkland Hospital], a public hospital for indigent patients in Dallas, Texas. They reported that 95% of the boys in their study were not [[circumcised]],<ref name="ginsburg uti"/>, and this piqued the interest of US Army pediatrician [[Thomas E. Wiswell]].

In a determined search for an association between the presence of the [[foreskin ]] and UTI, Wiswell et al. (1985) retrospectively examined charts of a number of boys born at U.S. military hospitals.<ref>{{REFjournal

}}</ref> Based on their observations of these old charts, they reported that Intact [[intact]] boys had a slightly higher rate of bacteriuria (bacteria in the [[urine]]) than circumcised boys during their first year of life, leading to the sensational statistic that [[circumcision ]] resulted in a "ten to hundred times decrease in urinary tract infections in circumcised boys."

* No information on rooming-in or breastfeeding history for the infants before they were hospitalized was recorded. [[Breastfeeding ]] and rooming-in are important factors in the prevention of UTI.<ref name="Winberg 1989"/> (See above.)

Wiswell's sensational statistic, that [[circumcision ]] resulted in a "ten to hundred times decrease in urinary tract infections in circumcised boys," has often been quoted; however, it is misleading. In fact, UTIs are so rare in either case that,even giving Wiswell's data the benefit of the doubt, 50 to 100 healthy boys would have to be circumcised in order to prevent a UTI from developing in only one patient. Using more recent data from a better-controlled study, the number of unnecessary operations needed to prevent one hospital admission for UTI would jump to 195.<ref>{{REFjournal

The notion that [[circumcision ]] is a useful prophylactic against UTI has been laid to rest by the 1999 AAP Task Force on Circumcision.<ref name="AAP 1999"/> Instead, healthy, natural alternatives such as [[breastfeeding ]] and rooming-in must be given favor. Breastfeeding offers a wide range of benefits for both mother and baby. Circumcision is surgery, and as such it has attendant risks, which include includes UTI itself.The proper treatment of UTI, if it occurs, is antimicrobial.<ref name="McCracken 1989" />

|publisher=Genital Autonomy AmericaPresented at The First International Symposium on Circumcision, Anaheim, California, March 1-2, 1989.

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]